The Canadian Hypoglycaemia During Hospitalisation (HyDHo) Score is Externally Valid in the Australian DINGO Cohort of Adults with Diabetes.

OBJECTIVE: The Hypoglycaemia During Hospitalization (HyDHo) score predicts hypoglycaemia in a population of Canadian inpatients by assigning various weightings to five key clinical criteria known at the time of admission: age, recent presentation to an emergency department, insulin use, oral hypoglycaemic use, and chronic kidney disease. The aim of the present study is to externally validate the HyDHo score by applying this risk calculator to an Australian population of inpatients with diabetes.

METHOD: This study was a retrospective data analysis of a subset of the Diabetes IN-hospital: Glucose & Outcomes cohort. The HyDHo score was applied based on clinical information known at the time of admission to stratify risk of inpatient hypoglycaemia.

RESULTS: The HyDHo score was applied to 1,015 patients, generating a receiver operating characteristic c-statistic of 0.607. A threshold of ≥9, as per the original study, generated a sensitivity of 83% and specificity of 20%. A threshold of ≥10, to better suit this Australian population, generated a sensitivity of 90% and specificity of 34%.

DISCUSSION: The HyDHo score is externally valid in a geographically different population, and in fact has outperformed the original study after accounting for local hypoglycaemia rates.

CONCLUSION: This study supports the external validity of the HyDHo score in a geographically different population. This supports the application of a simple and accessible tool which can be used as an adjunct to predict an inpatient's risk of hypoglycaemia and therefore guide more appropriate glucose monitoring and diabetes management.